Organization
SANFORD MEDICAL CENTER FARGO
Active
Other names
Sanford Health Forman Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TONY LEE MORRISON (VICE PRESIDENT, REVENUE CYCLE)
(605) 328-8380
Entity
Organization
Contact information
Practice address
336 MAIN STREET, FORMAN, ND 58032-0184
(701) 724-3221
(701) 724-3222
Mailing address
PO BOX 2168, FARGO, ND 58107-2168
(701) 234-2119
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12857
—
ND
01
—
1331001
BLUE SHIELD
ND
05
—
5128
—
ND
01
—
CF8850
RAILROAD MEDICARE
ND
Enumeration date
08/02/2006
Last updated
11/29/2022
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